[Value of non-invasive models of liver fibrosis in judgment of treatment timing in chronic hepatitis B patients with ALT < 2×upper limit of normal]

Objective: To investigate the value of non-invasive liver fibrosis models, FIB-4, S index, aspartate aminotransferase to platelet ratio index(APRI), globulin-platelet(GP)model, aspartate aminotransferase/platelet/gamma-glutamyl transpeptidase/alpha-fetoprotein(APGA), and platelet/age/phosphatase/alpha-fetoprotein/aspartate aminotransferase(PAPAS), in the diagnosis of marked liver fibrosis in chronic hepatitis B(CHB)patients with ALT < 2×upper limit of normal(ULN), as well as treatment timing for this population. Methods: A total of 389 CHB patients with ALT < 2×ULN who were admitted to Beijing Ditan Hospital and whose treatment timing was difficult to judge were enrolled. Transdermal liver biopsy was performed to obtain pathological results, and routine serological tests were performed, including routine blood test, serum biochemical parameters, hepatitis B virus(HBV)markers, and HBV DNA. According to liver pathology, the patients were divided into non-marked liver fibrosis group(S < 2)with 324 patients and marked liver fibrosis group(S≥2)with 65 patients. The non-invasive models for predicting liver fibrosis was established with reference to original articles. SPSS 19.0 software was used for statistical analysis, and the receiver operating characteristic(ROC)curve was used to compare the value of different non-invasive models in predicting marked liver fibrosis in this population. Results: All the non-invasive models had a certain diagnostic value for liver fibrosis degree in these patients, and the areas under the ROC curve for APRI, FIB-4, APGA, S index, PAPAS, and GP model were 0.718, 0.691, 0.758, 0.729, 0.673, and 0.691, respectively. APGA had the largest area under the ROC curve(0.758, 95% CI 0.673-0.844), and gamma-glutamyl transpeptidase was significantly positively correlated with liver fibrosis degree. Conclusion: The non-invasive models of liver fibrosis can identify marked liver fibrosis in CHB patients with ALT < 2×ULN in whom it is difficult to judge treatment timing and help to determine treatment timing for them. APGA model has the highest value and can reduce the need for liver biopsy to the certain degree.

[Correlation of the degree of band 3 protein absence on erythrocyte membrane by eosin-5'-maleimide binding test and clinical phenotype in hereditary spherocytosis]

目的

探讨伊红-5′-马来酰亚胺标记的流式细胞术（EMA结合试验）检测红细胞膜骨架带3蛋白缺失程度与遗传性球形红细胞增多症（hereditary spherocytosis，HS）临床表现型的关系。

方法

分析258例未行脾切除术治疗的HS患者临床和实验室特征，评估EMA结合试验结果与贫血程度、溶血和造血代偿参数的关系。

结果

258例HS患者中，男128例，女130例，中位年龄23（2~70）岁。代偿性溶血91例、轻度贫血53例、中度贫血78例、重度贫血36例。EMA结合试验荧光强度减低中位数为29.97%（16.09%~47.34%），平均数为（29.70±6.28）%。荧光强度减低程度与红细胞平均体积呈负相关（r=−0.343，P<0.001），与红细胞平均血红蛋白浓度呈正相关（r=0.223，P<0.001），与网织红细胞比例（r=−0.015，P=0.813）和绝对值（r=0.080，P=0.198）均无明显相关性，与血清间接胆红素水平无明显相关（r=−0.009，P=0.902），与HGB水平无明显相关性（r=−0.067，P=0.280）。按EMA标记缺失程度四分位区间分组，不同EMA标记缺失组与HS贫血严重程度分组亦无明显相关性（C=0.150，P=0.746）。

结论

EMA结合试验结果与HS贫血程度无关。

Association of cytokine gene polymorphisms (IL‑6, IL‑12B, IL‑18) with Behcet's disease : A meta-analysis

PURPOSE

This study aims to investigate the association of cytokine gene polymorphisms with the risk of Behcet's disease (BD) via comprehensive meta-analysis.

METHODS

The Embase and PubMed databases covering the period from the earliest possible year to May 2015 were searched. A total of 13 eligible articles including 2,065 BD patients and 1,559 controls were recruited. Odds ratios (ORs) and 95 % confidence intervals (CIs) were used to assess the strength of the associations. Potential publication bias was evaluated using Egger's linear regression test.

RESULTS

Meta-analysis indicated associations between IL‑6 rs1800795, IL‑12B rs3212227, and IL‑18 rs1946518 in all study subjects: IL‑18 rs1946518 in the dominant model (IL‑18 rs1946518: OR = 0.48, 95 % CI: 0.34-0.70, P = 0.000) and the homozygote model (IL‑18 rs1946518: OR = 0.40, 95 % CI: 0.25-0.65, P = 0.000); and IL‑6 rs1800795 and IL‑12B rs3212227 in the dominant model (IL‑6 rs1800795: OR = 0.53, 95 % CI: 0.39-0.72, P = 0.000; IL‑12B rs3212227: OR = 1.26, 95 % CI: 1.06-1.48, P = 0.007; IL‑18 rs1946518: OR = 0.46, 95 % CI: 0.33-0.65, P = 0.000). No significant evidence for associations of IL‑18 rs187238 polymorphisms with BD susceptibility was detected.

CONCLUSION

In summary, this meta-analysis finds that IL‑6 rs1800795 and IL‑18 rs1946518 polymorphisms decrease the risk of BD. However, IL‑12B rs3212227 increases BD susceptibility. Further large-scale investigation of this association is necessary.

Refractive index and temperature sensitivity characterization of excessively tilted fiber grating

We have investigated experimentally and numerically the temperature and refractive index (RI) sensitivity characteristics of excessively tilted fiber gratings (Ex-TFGs) in detail. Both results have shown that the temperature and RI sensitivities of Ex-TFGs are mode order dependent. For temperature sensitivity, the higher order cladding mode of Ex-TFG exhibited lower temperature sensitivity, quantitatively, the temperature sensitivities of TM cladding modes at the resonance wavelength around 1550nm are 9pm/°C, 6.8pm/°C, 5.6pm/°C and, 4pm/°C for cladding mode 28th, 31st, 35th, 40th, respectively, indicating the overall temperature sensitivity of Ex-TFGs were lower than that of normal FBGs. The SRI sensing results have shown that the RI sensitivity of Ex-TFG at the special index value could be improved by choosing the cladding mode with effective index close to the refractive index of the detecting medium. The SRI sensitivities at the effective mode index were 2250nm/RIU at 1.408, 864nm/RIU at 1.395, 1536nm/RIU at 1.380 and 1360nm/RIU at 1.355, for the cladding mode of 28th, 31st, 35th, 43rd, respectively. The experimental results have also shown the SRI sensitivity of Ex-TFG was increasing with increasing of the resonance wavelength.

Variants in Pharmacokinetic Transporters and Glycemic Response to Metformin: A Metgen Meta-Analysis

Therapeutic response to metformin, a first-line drug for type 2 diabetes (T2D), is highly variable, in part likely due to genetic factors. To date, metformin pharmacogenetic studies have mainly focused on the impact of variants in metformin transporter genes, with inconsistent results. To clarify the significance of these variants in glycemic response to metformin in T2D, we performed a large-scale meta-analysis across the cohorts of the Metformin Genetics Consortium (MetGen). Nine candidate polymorphisms in five transporter genes (organic cation transporter [OCT]1, OCT2, multidrug and toxin extrusion transporter [MATE]1, MATE2-K, and OCTN1) were analyzed in up to 7,968 individuals. None of the variants showed a significant effect on metformin response in the primary analysis, or in the exploratory secondary analyses, when patients were stratified according to possible confounding genotypes or prescribed a daily dose of metformin. Our results suggest that candidate transporter gene variants have little contribution to variability in glycemic response to metformin in T2D.

[Comparison of efficacy and safety of two different dose of recombinant human thrombopoietin regimens in severe aplastic anemia patients with immunosuppressive therapy]

目的

比较不同重组人TPO（rhTPO）方案联合免疫抑制剂治疗重型再生障碍性贫血（SAA）的近期疗效。

方法

回顾性分析接受一线免疫抑制治疗（IST）的61例成人SAA初诊患者资料，对比分析18例IST联合rhTPO每日1次（连续组）与43例IST联合rhTPO隔日1次（间日组）患者的疗效差异。

结果

两组患者在IST前基础临床特征差异无统计学意义。IST后3个月和6个月进行疗效评估，连续组与间日组患者总体血液学反应率比较差异无统计学意义（3个月：50.0%对51.2%，P= 0.934；6个月：77.8%对69.8%，P=0.525）。连续组IST后3个月良好血液学反应率明显高于间日组（38.9%对9.3%，P=0.011）。rhTPO应用后4周和8周两组脱离红细胞输注率差异无统计学意义（4周：22.2%对18.6%，P=0.736; 8周：55.6%对46.5%，P=0.519），而治疗后8周脱离血小板输注率连续组明显高于间日组（88.9%对48.8%，P=0.003）。每日连续应用rhTPO治疗并不增加不良反应事件的发生。

结论

每日1次较隔日1次应用rhTPO促进SAA造血恢复和减少血小板输注依赖更为有效。

[Hepatitis-associated aplastic anaemia: clinical characteristics and immunosuppressive therapy outcomes]

目的

分析肝炎相关再生障性贫血（HAAA）临床特征，评价其免疫抑制治疗（IST）疗效及生存状况。

方法

回顾性分析944例接受IST的重型／极重型AA（SAA/VSAA）患者，比较41例HAAA患者与年龄、造血衰竭程度相匹配的123例特发性AA（IAA）临床特征、血液学反应率、长期生存率及克隆性演变情况。

结果

944例SAA/VSAA患者中HAAA 41例（4.34%），HAAA患者中VSAA所占比例明显高于IAA患者（65.9％对39.4%，P=0.001）。HAAA与匹配的IAA比较，患者感染发生率差异无统计学意义，但感染控制所需时间明显延长[21 (4~100) d对13 (3~139) d，P=0.048]。HAAA患者CD3⁺、CD3⁺CD4⁺、CD3⁺CD8⁺ T淋巴细胞绝对值及CD4⁺/CD8⁺细胞比值均明显低于IAA患者，而CD3⁺ CD8⁺ T淋巴细胞比例明显高于IAA患者，差异均有统计学意义。HAAA与IAA患者IST后3个月（34.1％对34.1%，P=1.000）、6个月（56.1％对53.7%，P=0.787）及12个月（73.2％对68.3%，P=0.558）血液学反应率差异无统计学意义，两组患者预期5年总生存（OS）率、无事件生存（EFS）率比较差异均无统计学意义（OS率：90.0％对87.1%，P=0.700；EFS率：71.9％对62.4%，P=0.450）。

结论

HAAA少见，造血衰竭更为严重，感染相对难以控制，采用标准IST方案治疗可获得与IAA患者相当的疗效。

Evidence for the transition from primary to peritectic phase growth during solidification of undercooled Ni-Zr alloy levitated by electromagnetic field

The Ni_83.25Zr_16.75 peritectic alloy was undercooled by electromagnetic levitation method up to 198 K. The measured dendritic growth velocity shows a steep acceleration at a critical undercooling of ΔT_crit = 124 K, which provides an evidence of the transition of the primary growth mode from Ni₇Zr₂ phase to peritectic phase Ni₅Zr. This is ascertained by combining the temperature-time profile and the evolution of the solidified microstructures. Below the critical undercooling, the solidified microstructure is composed of coarse Ni₇Zr₂ dendrites, peritectic phase Ni₅Zr and eutectic structure. However, beyond the critical undercooling, only a small amount of Ni₇Zr₂ phase appears in the solidified microstructure. The dendritic growth mechanism of Ni₇Zr₂ phase is mainly governed by solute diffusion. While, the dendritic growth mechanism of Ni₅Zr phase is mainly controlled by thermal diffusion and liquid-solid interface atomic attachment kinetics.

Spatial and Temporal Dependence of Diffusion in Polystyrene Thin Films on Silicon and Carbon Surfaces

The strong inhibition of chain diffusion in thin polystyrene (PS) films has been observed near an attractive silicon surface, and diffusion remains inhibited out to distances of several radii of gyration from the surface. The present study seeks to determine the time dependence of the diffusion coefficient, and to examine the effect of a carbon surface on this diffusion. The sputter-deposited carbon surface may serve as a model for carbon-black particles employed in nanocomposites, which have recently been observed to reduce diffusion throughout a nanocomposite layer. The experiments employed a thin (∼15 nm) deuterated polystyrene (dPS) marker layer sandwiched between two normal PS layers. Deuterium profiles were monitored in the annealed samples by secondary ion mass spectrometry. Strong segregation was observed at the silicon surface, but was inhibited at the carbon surface, allowing the diffusion behaviour to be studied in the latter case over longer annealing times. A finite-element computer program was developed to fit the observed diffusion profiles. The variation of the diffusion coefficient with depth is shown to be consistent with previous results, and diffusion is comparable at both the carbon and silicon surfaces. The diffusion coefficient decreases roughly in proportion to t−1/2, and is discussed in the context of reptation theory.

Investigation of the size effect for photonic crystals

Three types of photonic crystal (PC) thin films have been prepared for the investigation of their deformation behaviors by nanoindentation tests at the microscale and nanoscale. Each type of PC thin film was composed of poly(methyl methacrylate) (PMMA) nanoparticles with a uniform size. Another type of thin film was prepared by assembling nanoparticles with three different sizes. It was exciting to observe that the hardness and Young's modulus were significantly improved (more than 15 times) in well-ordered PC thin films than disordered ones. Furthermore, size-dependent mechanical properties were observed for the three types of PCs. Such a size effect phenomenon can be attributed to the special polycrystalline material having a periodical face-centered cubic structure of PC thin films. Furthermore, the indentation size effect that shows that the indentation hardness decreases with an increasing indentation depth has also been observed for all four types of thin films. It is conjectured that the application of the PC structure to other functional materials may enhance their mechanical properties.

A self-assembling β-peptide hydrogel for neural tissue engineering

We report a new class of β-peptide based hydrogel for neural tissue engineering. Our β-peptide forms a network of nanofibres in aqueous solution, resulting in a stable hydrogel at physiological conditions. The hydrogel shows excellent compatibility with neural cells and provides a suitable environment for cells to adhere and proliferate.

In Vitro Chromatin Assembly: Strategies and Quality Control

Chromatin accessibility is modulated by structural transitions that provide timely access to the genetic and epigenetic information during many essential nuclear processes. These transitions are orchestrated by regulatory proteins that coordinate intricate structural modifications and signaling pathways. In vitro reconstituted chromatin samples from defined components are instrumental in defining the mechanistic details of such processes. The bottleneck to appropriate in vitro analysis is the production of high quality, and quality-controlled, chromatin substrates. In this chapter, we describe methods for in vitro chromatin reconstitution and quality control. We highlight the strengths and weaknesses of various approaches and emphasize quality control steps that ensure reconstitution of a bona fide homogenous chromatin preparation. This is essential for optimal reproducibility and reliability of ensuing experiments using chromatin substrates.

Emergence of pan-resistance in KPC-2 carbapenemase-producing Klebsiella pneumoniae in Crete, Greece: a close call

OBJECTIVES

KPC-2-producing Klebsiella pneumoniae (KPC-KP) ST258 has been rapidly expanding and is often associated with serious nosocomial infections. Last-line antibiotics such as colistin and tigecycline often remain the only treatment option. We describe here the evolving genetic background of KPC-KP isolates in Crete, Greece.

METHODS

We tested the antibiotic susceptibility of 34 clinical isolates from patients hospitalized in 2010 and 2013-14. Whole-genome sequences of these isolates were analysed for acquired resistance genes and gene mutations.

RESULTS

All KPC-KP isolates belonged to ST258 with the exception of one ST147 isolate. From 2014, 26% of isolates were non-susceptible to all antibiotics, compared with 0 of 11 isolates from 2010. Colistin resistance was associated with mutations in mgrB, which was present in 61% of isolates from 2014. Core-genome MLST analysis showed that pan-resistant isolates were closely related and appeared in two separate clusters.

CONCLUSIONS

KPC-KP is rapidly evolving to pan-resistance in Crete. We identified molecular resistance markers for pan-resistant isolates and showed that core-genome MLST is a promising tool for molecular fingerprinting of KPC-KP ST258.

A genome-wide association study suggests an association of Chr8p21.3 (GFRA2) with diabetic neuropathic pain

Background

Neuropathic pain, caused by a lesion or a disease affecting the somatosensory system, is one of the most common complications in diabetic patients. The purpose of this study is to identify genetic factors contributing to this type of pain in a general diabetic population.

Method

We accessed the Genetics of Diabetes Audit and Research Tayside (GoDARTS) datasets that contain prescription information and monofilament test results for 9439 diabetic patients, among which 6927 diabetic individuals were genotyped by Affymetrix SNP6.0 or Illumina OmniExpress chips. Cases of neuropathic pain were defined as diabetic patients with a prescription history of at least one of five drugs specifically indicated for the treatment of neuropathic pain and in whom monofilament test result was positive for sensory neuropathy in at least one foot. Controls were individuals who did not have a record of receiving any opioid analgesics. Imputation of non‐genotyped SNPs was performed by IMPUTE2, with reference files from 1000 Genomes Phase I datasets.

Results

After data cleaning and relevant exclusions, imputed genotypes of 572 diabetic neuropathic pain cases and 2491 diabetic controls were used in the Fisher's exact test. We identified a cluster in the Chr8p21.3, next to GFRA2 with a lowest p‐value of 1.77 × 10⁻⁷ at rs17428041. The narrow‐sense heritability of this phenotype was 11.00%.

Conclusion

This genome‐wide association study on diabetic neuropathic pain suggests new evidence for the involvement of variants near GFRA2 with the disorder, which needs to be verified in an independent cohort and at the molecular level.

Neurodevelopmental delay with critical congenital heart disease is mainly from prenatal injury not infant cardiac surgery: current evidence based on a meta-analysis of functional magnetic resonance imaging

OBJECTIVE

No consensus has been reached regarding whether brain injury related to congenital heart disease (CHD) is caused by infant cardiac surgery and/or prenatal injury resulting from the CHD. We performed this meta-analysis to identify the likely cause of neurodevelopmental delay in CHD patients.

METHODS

We carried out a literature search without language restriction in December 2013, retrieving records from PubMed, EMBASE, the Cochrane Library and the World Health Organization trials center, to identify studies applying functional magnetic resonance imaging (fMRI) evaluation of brain function before surgery and, in some cases, after surgery (both immediate term and short term postoperatively). The preoperative and postoperative fMRI results were extracted, and meta-analysis was performed using Revman 5.1.1 and STATA 11.0, according to the guidelines from the Cochrane review and MOOSE groups.

RESULTS

The electronic search yielded 937 citations. Full text was retrieved for 15 articles and eight articles (nine studies) were eligible for inclusion: six studies (n = 312 cases) with fMRI analysis before surgery and three (n = 36 cases) with complete perioperative fMRI analysis. The overall average diffusivity of CHD cases was significantly higher than that of controls, with a summarized standard (std) mean difference of 1.39 (95% CI, 0.70-2.08), and the fractional anisotropy was lower in CHD cases, with a summarized mean difference of -1.43 (95% CI, -1.95 to -0.91). N-acetylaspartate (NAA)/choline (Cho) for the whole brain was significantly lower in CHD cases compared with healthy ones, while lactate/Cho was significantly higher in CHD cases. Immediate term postoperatively, significant changes in NAA/creatine and NAA/Cho, relative to preoperative values, were found. However, the difference did not persist at the short-term follow-up.

CONCLUSION

This meta-analysis suggests that the delay in neurological development in newborns with CHD is due mainly to prenatal injury, and cardiac surgery might lead to mild brain injuries postoperatively, but fMRI shows recovery within a short period.

The synthesis and structure of chiral enamine N-oxides

Chiral enamine N-oxides have been synthesised by a diastereoselective intermolecular reverse-Cope cycloaddition reaction between chiral hydroxylamines and activated acetylenes. Their structures have been investigated by NMR, X-ray crystallography and computational methods.

Coronary artery fistula in adults: evaluation with dual-source CT coronary angiography

OBJECTIVE

To evaluate the clinical value of dual-source CT (DSCT) coronary angiography in the diagnosis of coronary artery fistula (CAF) in adults.

METHODS

A large cohort of 17,548 patients, who underwent DSCT coronary angiography in our hospital between January 2008 and October 2013, were retrospectively reviewed for CAF. The origin, course and drainage site of CAF and coexisting abnormalities were analysed. The conventional angiography results, treatments and follow-up DSCT images were also evaluated.

RESULTS

A total of 33 CAFs from 17,548 patients were detected. The incidence of CAF was 0.19% by DSCT. CAF originating from the left coronary artery (LCA) was found in 14 (42.4%) patients, from right coronary artery (RCA) in 4 (12.1%) cases and from both LCA and RCA in 15 (45.5%) patients. The pulmonary artery was the most common site of drainage (28/33, 84.8%). 8 of the 33 (24.2%) cases were associated with aneurysms. Six cases were associated with coronary artery atherosclerosis. Four patients underwent conventional angiography.

CONCLUSION

Coronary-pulmonary artery fistula in adults was found more often than in previous studies. CAF commonly originates from LCA or both LCA and RCA in adults. DSCT is a robust tool for investigating the origin, course and drainage site of CAF and coexistent abnormalities.

ADVANCES IN KNOWLEDGE

A large adult patient cohort who underwent DSCT angiography was reviewed to assess CAFs. Coronary-pulmonary artery fistula in adults was found more often than in previous studies. CAF was observed to originate from the LCA or both coronary arteries in adults. DSCT could clearly depict the fistula origin, course, drainage site and coexisting abnormalities. Conventional angiography results, treatments and follow-up DSCT images were analysed.

Simulation of Soot Size Distribution in a Counterflow Flame

Soot formed during the rich combustion of fossil fuels is an undesirable pollutant and health hazard. A newly developed Monte Carlo method is used to simulate the soot formation in a counterflow diffusion flame of ethylene. The simulation uses a new reaction mechanism available in literature, which focuses on modeling the formation of large polycyclic aromatic hydrocarbons (PAHs) up to coronene (C24H12). Nascent soot particles are assumed to form from the collision of eight different PAH molecules. Soot surface growth includes the hydrogen-abstraction-C2H2-addition mechanism and the condensation of the PAHs. Soot coagulation is in the free-molecular regime because particles are small (not more than a hundred nanometer). The coupling between vapor consumption and soot formation is handled by an interpolative moment method. Soot particle diffusion is found negligible throughout the counterflow flame, except for a very narrow region right around the stagnation plane. The soot particle size distribution (PSD) generally exhibits a bimodal shape. The first peak corresponds to a large number of nascent particles, while the second peak results from the competition between nucleation and coagulation. Surface growth affects the PSD quantitatively, but does not change the modality. A comparison with experimental data is also provided.

The mosaic genome structure and phylogeny of Shiga toxin-producing Escherichia coli O104:H4 is driven by short-term adaptation

Shiga toxin-producing Escherichia coli (STEC) O104:H4 emerged as an important pathogen when it caused a large outbreak in Germany in 2011. Little is known about the evolutionary history and genomic diversity of the bacterium. The current communication describes a comprehensive analysis of STEC O104:H4 genomes from the 2011 outbreak and other non-outbreak-related isolates. Outbreak-related isolates formed a tight cluster that shared a monophyletic relation with two non-outbreak clusters, suggesting that all three clusters originated from a common ancestor. Eight single nucleotide polymorphisms, seven of which were non-synonymous, distinguished outbreak from non-outbreak isolates. Lineage-specific markers indicated that recent partitions were driven by selective pressures associated with niche adaptation. Based on the results, an evolutionary model for STEC O104:H4 is proposed. Our analysis provides the evolutionary context at population level and describes the emergence of clones with novel properties, which is necessary for developing comprehensive approaches to early warning and control.

High-intensity focused ultrasound ablation: an effective and safe treatment for secondary hypersplenism

OBJECTIVE

Hypersplenism is a common disease. The conventional treatment is splenectomy and partial splenic embolization; however, both of them have high complication rates and technical defects. Therefore, safer and more effective techniques should be considered for the treatment of hypersplenism. High-intensity focused ultrasound (HIFU) may provide an effective and safe way for treatment of hypersplenism. Therefore, we conducted this study to assess the safety and efficacy of HIFU in treatment of secondary hypersplenism.

METHODS

A total of 28 patients who suffered from secondary hypersplenism were treated with HIFU ablation. All patients who underwent HIFU were closely followed-up over a year. MRI scan was performed, and the spleens were observed. Blood counts and liver function tests were also carried out.

RESULTS

In the follow-up process, the levels of white blood cells and platelets in the blood after HIFU were significantly higher than those before HIFU, liver function also improved after HIFU treatment. In addition, the symptoms were ameliorated significantly or even disappeared. The MRI showed that the ablation area had turned into a non-perfused volume, and after 12 months of HIFU ablation, the ablated area shrank evidently; the sunken spleen formed a lobulated shape and the splenic volume decreased.

CONCLUSION

HIFU ablation is a safe, effective and non-invasive approach for secondary hypersplenism.

ADVANCES IN KNOWLEDGE

For the first time we used HIFU ablation to treat secondary hypersplenism. It not only expands indications of HIFU but also provides better choice for the treatment of secondary hypersplenism.

Selective trioxolane based bifunctional molecular linkers for covalent heme surface functionalisation

A bifunctional molecular linker containing both aryl diazonium and trioxolane groups was synthesised and its ability to sequentially functionalise glassy carbon and covalently immobilise heme investigated. Functionalisation was demonstrated by electrochemical techniques.

Fabrication of PDMS micro through-holes using micromolding in open capillaries

Micromolding in open capillaries, a simpler method for PDMS through-holes fabrication, whose procedures are easy to handle and observe.

Clinical application and prognostic assessment of serum Tumor Associated Material (TAM) from esophageal cancer patients

OBJECTIVE

To explore the correlation between serum levels of Tumor Associated Materials (TAM) and clinicopathological parameters and prognosis in patients with esophageal cancer (EC).

PATIENTS AND METHODS

The levels of TAM were determined by chemical colorimetry in 100 EC patients and 100 healthy controls.

RESULTS

Serum TAM levels were significantly higher in patients with esophageal carcinoma than in the control group (p < 0.001). High levels of TAM were associated with tumor size (p = 0.004), tumor depth (p < 0.001), stage (p < 0.001), lymph node metastases (p < 0.001), tumor differentiation (p = 0.001), tumor respectability (p = 0.002) and disease progression (p < 0.001). The poor prognostic outcomes were correlated with an elevated level of TAM (p = 0.001). Kaplan-Meier analysis showed patients with increased levels of TAM after operation had an lower overall survival (p < 0.001) and disease-free survival (p < 0.001). In addition, multivariate Cox proportional hazard analyses revealed that TAM may be an independent factor affecting the overall survival and disease-free survival (p < 0.001).

CONCLUSIONS

The detection of TAM could be used to screen for tumor and assess unfavorable prognosis in patients with EC.

Opening of a Peierls gap in BaVS3 probed by V L3 edge resonant inelastic x-ray scattering

V L3 edge resonant inelastic x-ray scattering measurements performed on high quality BaVS3 single crystals reveal that the intra-t2g dd excitations close to the elastic peak are suppressed below the metal-insulator transition induced by the Peierls instability. The depletion of electronic states close to the Fermi level represents a direct observation of the opening of a charge gap inside the t2g manifold.

Latent introduction to the Netherlands of multiple antibiotic resistance including NDM-1 after hospitalisation in Egypt, August 2013

We describe the introduction of various multi-drug resistant bacterial strains, including an NDM-1-producing Klebsiella pneumoniae, through a traveller returning from Egypt, where they had been admitted to a private hospital. All family members of the patient were colonised with one or more extended-spectrum beta-lactamase producing strains. These findings emphasise the importance of adherence to isolation precautions for returning patients and suggest the need for inclusion of Enterobacteriaceae in admission screening.

miR-200b inhibits TGF-β1-induced epithelial-mesenchymal transition and promotes growth of intestinal epithelial cells

Inflammatory bowel disease (IBD), which consists of Crohn's disease (CD) and ulcerative colitis (UC), is a chronic, inflammatory disorder of the gastro-intestinal tract with unknown etiology. Current evidence suggests that intestinal epithelial cells (IECs) is prominently linked to the pathogenesis of IBD. Therefore, maintaining the intact of epithelium has potential roles in improving pathophysiology and clinical outcomes of IBD. MicroRNAs (miRNAs) act as post-transcriptional gene regulators and regulate many biological processes, including embryonal development, cell differentiation, apoptosis and proliferation. In this study, we found that miR-200b decreased significantly in inflamed mucosa of IBD, especially for UC, when compared with their adjacent normal tissue. Simultaneously, we also found that the genes of E-cadherin and cyclin D1 were reduced significantly and correlated positively to the miR-200b. In addition, the upregulation of transforming growth factor-beta 1 (TGF-β1) was inversely correlated to the miR-200b in IBD. To investigate the possible roles of miR-200b in IECs maintaining, we used TGF-β1 to induce epithelial-mesenchymal transition (EMT) in IEC-6 initially. After sustained over-expressing miR-200b in IEC-6, the EMT was inhibited significantly that was characterized by downregulation of vimentin and upregulation of E-cadherin. Furthermore, we found that miR-200b enhanced E-cadherin expression through targeting of ZEB1, which encode transcriptional repressors of E-cadherin. SMAD2 was found to act as a target of miR-200b with direct evidence that miR-200b binding to the 3′ UTR of SAMD2 and the ability of miR-200b to repress SMAD2 protein expression. With SMAD2 depletion, the expression of vimentin decreased correspondingly, which suggested miR-200b might reduce vimentin through regulating the SMAD2. With endogenous over-expression of miR-200b, the proliferation of IEC-6 cells increased significantly by increasing S-phase entry and promoting expression of the protein cyclin D1. Summarily, our study suggested a potential role for mir-200b in maintaining intact of intestinal epithelium through inhibiting EMT and promoting proliferation of IECs.

A retrospective study of different treatments of limited-stage small-cell esophageal carcinoma and associated prognostic factor analysis

Primary, small-cell esophageal carcinoma (SCEC) is a rare but highly malignant tumor. Due to lack of randomized, controlled, prospective studies, there are currently no unified treatment modalities for SCEC. This study retrospectively analyzed the outcomes of different treatments and prognostic factors that influence overall survival in patients with limited-stage SCEC. The study included 106 patients pathologically diagnosed with limited-stage SCEC at Huai'an First People's Hospital, Nanjing Medical University (Huai'an, China), between 1998 and 2007. There were 66 males and 40 females, with a median age of 58 years (range: 45-77 years). Fourteen patients received surgery alone, 42 received surgery and postoperative chemotherapy, 11 received radiotherapy alone, and 39 received concurrent chemoradiotherapy. Combined modality treatment with and without chemotherapy yielded 5-year survival rates (5YSRs) of 27.2% and 0%, respectively. Associated median survival times were 22 months and 11 months, respectively, with a hazard ratio (HR) of 2.30 (95% confidence interval [CI]: 1.42-3.73, P = 0.001). Among patients treated with surgery plus postoperative chemotherapy or with concurrent chemoradiotherapy, the 5YSRs were 31.0% and 23.1%, respectively. Median survival times were 26 months and 18 months, with an HR of 1.25 (95% CI: 0.75-2.09, P = 0.725). Multivariate survival analysis using Cox regression model showed that chemotherapy was a positive independent prognostic factor for SCEC (HR 2.92, 95% CI: 1.25-6.80). Chemotherapy-based combined modality treatment appears to increase the long-term survival of patients with limited-stage SCEC. Similar overall survival rates results are achieved with surgery combined with chemotherapy as with concurrent chemoradiotherapy, with chemotherapy being an independent prognostic factor. Randomized, controlled, prospective studies are needed to identify optimal chemotherapy regimens for treating SCEC.